The Centers for Medicare and Medicaid Services (CMS) has issued guidelines regarding those instances when existing CAHs relocate. The guidelines appear to adhere to the same "75% rules" that were described in the final regulations published earlier this year. Hospitals nationwide worked hard to turn back CMS regulations that would preclude any CAH not currently in the midst of a construction project from relocating outside of its existing campus. The final regulations allowed relocation as long as the CAH in its new location—
"(i) Serves at least 75 percent of the same service area that it served prior to its relocation;
(ii) Provides at least 75 percent of the same services that it provided prior to the relocation; and
(iii) Is staffed by 75 percent of the same staff (including medical staff, contracted staff, and employees) that were on staff at the original location."
These requirements appear reasonable, but they are very general. As we all know, the application and interpretation is where the potential problems occur.